Payer Roundup—Republicans still lack the votes to repeal ACA; Groups urge CMS to protect patients who use oxygen

U.S. Capitol at dusk
Don't expect Congress to bring up any additional challenges to Obamacare before the midterms. (Pixabay/skeeze)

Republicans appear short on votes to repeal Obamacare

Even with an apparent "yes" vote from Arizona's new senator Jon Kyl, it appears Republicans still don't have the numbers they need—nor, it appears, the interest to try to repeal the Affordable Care Act, the Associated Press reported.

Republicans on Capitol Hill indicated they were not interested in revisiting legislation that was defeated last year with a notable "no" vote from the late Sen. John McCain, R-Ariz., even with a potential yes vote from Kyl. Senate Majority Leader Mitch McConnell, R-Ky., told the AP he has ruled out bringing up the healthcare fight before the midterms, in part because of the number of other bills including spending measures Congress is already focused on. (Associated Press article)

20 patient and physician groups urge CMS to protect patients who use oxygen

A coalition made up of 20 patient and physician groups, including the Pulmonary Fibrosis Foundation, is urging the Centers for Medicare & Medicaid Services (CMS) to protect patients who use supplemental oxygen. The organizations, which submitted comments on a proposed rule for durable medical equipment and its application to supplemental oxygen, want CMS to remove liquid oxygen from its competitive bidding requirements.


Home State Health Leverages Conversational AI to Activate Their Members, Address SDOH, and Improve Quality Measures

Like many health plans, engaging and activating vulnerable populations at scale is critical to Home State Health. This case study from Home State Health focuses on engaging Medicaid members at scale on numerous topics leading to desired outcomes including: working with the State to develop the most optimal opt-in program; the benefits of Conversational AI in orchestrating tailored dialogues at scale; and how to design and launch Conversational AI programs.

“Our organizations recognize that CMS’s proposal will not ultimately solve the problems facing patients—especially those who require liquid oxygen—and today, are urging CMS to remove liquid oxygen from competitive bidding requirements,” the groups wrote. (Announcement)

Oak Street Health purchases neighborhood clinics in Philadelphia

Oak Street Health, a network of primary care centers that operates on a value-based care model providing services to Medicare-eligible adults, has expanded with four new neighborhood clinics in Philadelphia.

Oak Street purchased the Medicare operations of CityLife Neighborhood Clinics and will serve patients with Medicare and Medicare Advantage at four of its centers. The acquisition expands on Oak Street Health’s entry into the Philadelphia market, with three existing locations. In addition to seven Philadelphia-area locations, Oak Street operates 40 other locations in Pennsylvania, Illinois, Indiana, Ohio and Michigan. (Announcement)

Gag clauses' measure advances in House

The House Energy and Commerce health subcommittee approved legislation to bar Medicare and private health plans from blocking pharmacists' ability to inform enrollees when a drug would cost less if they paid cash instead of using their insurance. The measure is meant to address so-called gag clauses in some health insurance contracts.

The subcommittee also passed a draft bill to give the Medicare Payment Advisory Commission, or MEDPAC—which advises Congress on Medicare issues—access to drug rebate information. (Washington Examiner article)

Suggested Articles

UnitedHealth's Optum unit has completed its $4.3 billion acquisition of DaVita Medical Group after getting the final OK from the Federal Trade Commission…

Cigna chief David Cordani said it’s time to pump the brakes on calls for a healthcare system overhaul like “Medicare for All.”

Uber is moving further into healthcare with a new partnership with startup Grand Rounds enabling some of the largest employers in the U.S. to cover the cost of…